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What Causes Swelling In Legs And Pain In Chest For Heart Patient?
Question: this question is pertaining to my Father who has undergone a heart by pass - triple vessel by pass at Medanta in October 2013.
additionally, he is a diabetic patient for many years and has Glucoma in the eyes.
At present he complains of swelling in legs and pain / heaviness in chest ( hear side ) at sometimes and says he can feel his heart pumping and blood flows .
additionally, he is a diabetic patient for many years and has Glucoma in the eyes.
At present he complains of swelling in legs and pain / heaviness in chest ( hear side ) at sometimes and says he can feel his heart pumping and blood flows .
Brief Answer:
please see details
Detailed Answer:
Dear madam
1. Swelling in feet can have many causes. These include kidney damage due to diabetes, low proteins in blood, right sided heart failure, venous insufficiency following removal of veins for bypass.
2. A pain or heaviness is a sign of angina if it is coming on exertion or associated with breathlessness. This may at times arise from scar region of bypass. It needs evaluation by his cardiologist. Nearly 10% of grafts may close after 1 year of surgery.
3. Heart pumping is common and benign if it occurs transiently. If this persist for longer periods or is associated with bothersome symptoms, it needs evaluation.
Sincerely
Sukhvinder
please see details
Detailed Answer:
Dear madam
1. Swelling in feet can have many causes. These include kidney damage due to diabetes, low proteins in blood, right sided heart failure, venous insufficiency following removal of veins for bypass.
2. A pain or heaviness is a sign of angina if it is coming on exertion or associated with breathlessness. This may at times arise from scar region of bypass. It needs evaluation by his cardiologist. Nearly 10% of grafts may close after 1 year of surgery.
3. Heart pumping is common and benign if it occurs transiently. If this persist for longer periods or is associated with bothersome symptoms, it needs evaluation.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Are there any tests to be done prior to showing to the cardilogists. comprehensive heart check up was done in the month of Feb 2014.
kindly suggest, we are planning on consuting his cardio surgeon in about a week.
Rgds
kindly suggest, we are planning on consuting his cardio surgeon in about a week.
Rgds
Brief Answer:
wait for consultation
Detailed Answer:
Dear madam
It is best to consult the doctor first and then get the directed investigations. This will reduce unnecessary investigation, wastage of money and discomfort to patient.
However, if you want some basic investigations then it includes hemogram, serum protein, serum creatinine, urine examination, chest xray, ultrasound kidneys and ECG. These are relevant to complaints of your father.
Sincerely
Sukhvinder
wait for consultation
Detailed Answer:
Dear madam
It is best to consult the doctor first and then get the directed investigations. This will reduce unnecessary investigation, wastage of money and discomfort to patient.
However, if you want some basic investigations then it includes hemogram, serum protein, serum creatinine, urine examination, chest xray, ultrasound kidneys and ECG. These are relevant to complaints of your father.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Diagnostic report details attached.
abdomen ultrasound reports normal aswell.
Swell in the feet still there , though lill reduced from the past.
any further diagnostics required or any medication to be altered kindly suggest.
abdomen ultrasound reports normal aswell.
Swell in the feet still there , though lill reduced from the past.
any further diagnostics required or any medication to be altered kindly suggest.
Brief Answer:
please see details
Detailed Answer:
Respected Ma'm
1. Except for marginally raised TSH all other investigations are almost normal and do not pinpoint the cause of swelling. This level of TSH alone is not sufficient to start medication unless he has some evidence of clinical features of hypothyroidism or he has high AMA antibodies. Needs an evaluation by physician for same.
2. As I told you in my last answer, no test/ investigation substitutes a good clinical examination and he needs to get one. Moreover two important causes of swelling, Venous insufficiency and right sided heart failure, can be picked up on clinical examination. Please get him examined by his cardiologist as well as surgeon to rule out these two conditions. Moreover his complaint of heaviness of chest will also get evaluated in detail.
Sincerely
Sukhvinder
please see details
Detailed Answer:
Respected Ma'm
1. Except for marginally raised TSH all other investigations are almost normal and do not pinpoint the cause of swelling. This level of TSH alone is not sufficient to start medication unless he has some evidence of clinical features of hypothyroidism or he has high AMA antibodies. Needs an evaluation by physician for same.
2. As I told you in my last answer, no test/ investigation substitutes a good clinical examination and he needs to get one. Moreover two important causes of swelling, Venous insufficiency and right sided heart failure, can be picked up on clinical examination. Please get him examined by his cardiologist as well as surgeon to rule out these two conditions. Moreover his complaint of heaviness of chest will also get evaluated in detail.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
what is venous insufficiency and whats the treatment ?
the Family doctor has started a medication for thyroid
also note that ECG and the chest Xray was normal.. i forgot to mention in my earlier mail.
the Family doctor has started a medication for thyroid
also note that ECG and the chest Xray was normal.. i forgot to mention in my earlier mail.
Brief Answer:
please see details
Detailed Answer:
Respected Ma'm
1. Veins are the blood vessels which carry dirty (deoxygenated) blood from peripheral organs to heart. These vessels have valves which prevent the blood flow in backward direction. These valve prevent blood to come towards feet in standing position. Similarly there are valves which prevent the backward flow in veins which connect the superficial veins to deep veins. Superficial veins drain into deep veins. If these valves become incompetent, there may be backward flow and consequent stasis in lower limbs. This leads to swelling of limbs. This is diagnosed by certain clinical tests. Venous doppler of lower limbs also help in same. There are multiple treatment option from compression stockings to surgical intervention. A surgeon preferably a vascular surgeon is best person to ascertain exact treatment.
Sincerely
Sukhvinder
please see details
Detailed Answer:
Respected Ma'm
1. Veins are the blood vessels which carry dirty (deoxygenated) blood from peripheral organs to heart. These vessels have valves which prevent the blood flow in backward direction. These valve prevent blood to come towards feet in standing position. Similarly there are valves which prevent the backward flow in veins which connect the superficial veins to deep veins. Superficial veins drain into deep veins. If these valves become incompetent, there may be backward flow and consequent stasis in lower limbs. This leads to swelling of limbs. This is diagnosed by certain clinical tests. Venous doppler of lower limbs also help in same. There are multiple treatment option from compression stockings to surgical intervention. A surgeon preferably a vascular surgeon is best person to ascertain exact treatment.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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